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正常时期与 COVID-19 大流行期间急性阑尾炎治疗的对比分析。

Comparative analysis of the management of acute appendicitis between the normal period and COVID-19 pandemic.

机构信息

Department of General Surgery, İstanbul Bağcılar Training and Research Hospital, İstanbul-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2021 Jan;27(1):22-25. doi: 10.14744/tjtes.2020.46487.

Abstract

BACKGROUND

Acute appendicitis is the most common abdominal surgical emergency. There is no adequate information to evaluate the effects of the COVID-19 pandemic on acute appendicitis and its surgical management. The present comparative study reports successful appendectomy and infection control in patients with appendicitis during the COVID-19 pandemic and last year covering the same period.

METHODS

This retrospective observational study was conducted in acute appendicitis-treated patients from 13.03.19 to 13.05.19 and from 13.03.20 to 13.05.20, respectively.

RESULTS

This study included 150 patients (110 patients in 2019; 40 patients in 2020 (during COVID-19 pandemic)). The patients were named as Group A (Normal period) and Group B (Pandemic period), respectively. The groups were comparable as there was no significant difference between the mean age, mean BMI, and mean length of stay. There is a significant difference between the comorbidities of Group A and Group B (p=0.033). There was no significant difference between the laboratory and radiological findings of Group A and Group B. There was a significant difference between the perforation number of Group A and Group B (p=0.029). There was no significant difference between the needs of ICU and conversion from laparoscopic to conventional appendectomy of Group A and Group B.

CONCLUSION

The findings obtained in this study suggest that late admission to the hospital caused complicated cases and made acute appendicitis management more difficult during the pandemic period, which was already a troubling period. During the COVID-19 pandemic, the principles applied to emergency surgery for infected patients should be applied to both suspected and confirmed cases.

摘要

背景

急性阑尾炎是最常见的腹部外科急症。目前尚无足够的信息来评估 COVID-19 大流行对急性阑尾炎及其手术治疗的影响。本比较研究报告了 COVID-19 大流行期间和去年同期治疗阑尾炎患者的成功阑尾切除术和感染控制情况。

方法

本回顾性观察研究分别纳入了 2019 年 3 月 13 日至 5 月 13 日和 2020 年 3 月 13 日至 5 月 13 日期间治疗的急性阑尾炎患者。

结果

本研究共纳入了 150 例患者(2019 年 110 例,2020 年 40 例(COVID-19 大流行期间))。将患者分别命名为 A 组(正常时期)和 B 组(大流行时期)。两组之间无显著差异,如平均年龄、平均 BMI 和平均住院时间。A 组和 B 组的合并症存在显著差异(p=0.033)。A 组和 B 组的实验室和影像学检查结果无显著差异。A 组和 B 组的穿孔例数存在显著差异(p=0.029)。A 组和 B 组的 ICU 需求和从腹腔镜转为传统阑尾切除术的比例无显著差异。

结论

本研究结果表明,大流行期间医院就诊时间延迟导致复杂病例增加,使急性阑尾炎管理更加困难,这已经是一个令人困扰的时期。在 COVID-19 大流行期间,应将应用于感染患者急诊手术的原则应用于疑似和确诊病例。

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